The Government recognises the pressures on the health and social care system. It is supporting the NHS’s own plan for the future and going further than ever before to integrate health and social care.

The Government knows that the NHS is facing many challenges and there are increasing pressures on all parts of the health and care system. It is important to remember that the pressures faced by the NHS are common to most developed health systems and are due to, amongst other things, an ageing population, changing public expectations and the cost of new drugs. However we have more doctors, more nurses, more paramedics all delivering more treatments than ever, funded by a budget at record levels.

The NHS and wider health system has already examined what needs to be done to ensure the sustainability of the health and care system. This is why in the Spending Review in November 2015, the Government committed to increase funding for the NHS in England, with funding to be £10 billion higher in real terms by 2020-21, compared to 2014-15. This is the money that the NHS in England asked for and will support the NHS’s own plan for its future – the Five Year Forward View – which set out what needs to change and how this can be achieved of this new funding. £6 billion will be provided by the end of this year, kick starting the process of change, and enabling the Government to deliver Government objectives including seven day services and improved access to cancer treatments and mental health services. The Five Year Forward View is available on NHS England’s website – https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf.

We are making progress towards strategic system changes and new models of care. There is emerging evidence that the vanguards have had a significant impact, reducing pressure on busy services at local level since their launch. In the Fylde Coast Local Health Economy vanguard for example, early figures show that bringing different health professionals under one roof to support older patients with multiple conditions reduced A&E attendance by 13%. We will continue to support this work to design a world class health system, fit for the future.

Alongside this, we are giving local authorities access of up to £3.5 billion of new support for social care by 2019-20, through the social care precept and the Better Care Fund. And aware of the more imminent pressures on social care, the Government took the necessary steps in the recent Local Government Settlement to help in the shorter-term, making available almost £900 million of additional social care funding over the next two years.

The Government believes that the answer to the challenges faced by the health and social care system lies in delivering more integrated services and keeping people well and independent for longer, and in working with the NHS in implementing its own plan for the future of the NHS – the Five Year Forward View.

The Petitions Committee will take a look at this petition and its response. They can press the government for action and gather evidence. If this petition reaches 100,000 signatures, the Committee will consider it for a debate.

David Cameron admits 'we didn't solve' problem of funding social care for Britain's ageing population

David Cameron has expressed regret he was unable to do more to deal with the “huge” challenge funding social care for Britain’s ageing population.

The former prime minister – who has since become president of Alzheimer’s Research UK – said a way had to be found to meet the “catastrophic” costs of caring for people with dementia.

1st December 2017

Sleep-in pay crisis:

should you join HMRC’s new Social Care Compliance Scheme?

The Government’s latest response to the sleep-in pay crisis is the introduction of a new Social Care Compliance Scheme (SCCS).

Under the scheme, providers who have not paid sleep-in shifts in compliance with the National Minimum Wage can self assess their non-compliance and repay workers with protection against HMRC enforcement action.

30th November 2017

Care homes: Public 'pay unfair fees to plug £1bn shortfall'

Care homes have been applying unfair charges and over-the-top fees for self-funders, an official review shows.

The Competition and Market Authority found some homes had applied large upfront costs and charged families for weeks after their relatives had died.

The watchdog also highlighted how those paying for themselves were charged much more than council-funded residents.

The average weekly charge for self-funders was £846 - 40% more than local authority rates.

28th November 2017

Care workers 'exhausted' by staff shortage

A care worker in Northern Ireland has said she feels like a "workhorse" because a shortage of staff means she often has to work 80 hours a week.

Her comments follow a BBC investigation into the current state of social care.

It reveals that on one day this month, 88 people had to stay in hospital unnecessarily, due to a wait for a suitable home care package.

The Department of Health said care demand has risen "considerably" and it is reviewing its domiciliary workforce.

14th November 2017

We can't fix social care if we think it's just for older people

There’s no doubt that one of the biggest challenges facing Britain is how we deal with our ageing population. The countless warnings about the crisis in social care leave no room for doubt. Over the last seven years, budgets have decreased by more than £6bn (pdf) in real terms, and more than 1.2 million older people are struggling to get by without proper care.

10th November 2017

Care 'will take up most of our council tax within three years': Rapid rise in costs could see fresh curbs on bin rounds, road repairs and street lighting

Most of our council tax will be needed to pay for the care of vulnerable children and the elderly within three years, councils declared yesterday.

They said the rapidly rising price of social care will mean fresh curbs on bin collections, road repairs, street lighting, buses and food safety checks.

The warning about the cost of care for the elderly and protection of children at risk was designed to pile pressure on Chancellor Philip Hammond in advance of the autumn budget. It follows a series of attempts by public sector leaders, including police chiefs and NHS managers, to extract more cash from the Chancellor.

9th November 2017

How to design websites for older people

Why it’s important to us

Dementia currently affects 850,000 people who are diagnosed. However, a dementia diagnosis also directly affects about 700,000 informal primary/family carers.

The average age of a family carer in the UK is between 60 and 65 years old. This is about 10 years older than the age where we typically begin to experience an acceleration in age-related physiological changes to our bodies.

2nd November 2017

Social care funding can't take any more setbacks. It needs reform now

For a short while, it seemed like the issue of social care funding would finally be addressed after years of government procrastination. The Conservatives promised a consultation on social care reform, U-turned on the so-called dementia tax and, instead, confirmed their intention to cap the amount people pay towards care.

But now that plans to introduce such a cap have been scrapped and the social care consultation is rumoured to have been delayed until next summer, it seems that the government has followed previous administrations and kicked social care funding into the long grass.

2nd November 2017

Overnight carer back pay scheme 'unaffordable'

Care providers have dismissed a government scheme to tackle a problem over back pay for overnight shift staff as a "suicide note".

The charity Mencap said the government was sacrificing the wellbeing of the most vulnerable in society and putting the jobs of low-paid staff at risk.

Ministers said the scheme had been designed to help ensure workers were paid what they were owed.

But charities say the bill for six years of extra pay is unaffordable.

29th October 2017

Why care costs are spiralling at up to twice inflation

The average cost of a care home place has almost doubled over the past two decades and is now nearing £1,000 a week, according to the latest data.

A cruel combination of short supply, care home operators falling into financial difficulty and tightening local authority budgets means private payers – those who get no assistance with fees – are especially hard hit.

Research carried out earlier this year by industry experts LaingBuisson found that the average weekly fee for residential care with nursing had risen from £445 in 1998 to £845 this year.

27th October 2017

Lack of choice means families have to settle for poor care homes: Nearly a fifth are forced to leave loved ones in a home they have reservations about because of a shortage of places

'Systematic failures' mean half of those needing care have to wait for a bed

The lack of places meant 17 per cent of families were forced to move their loved ones into care homes that they had reservations about

And 16 per cent of families had to opt for a home away from friends and family

23rd October 2017

A job in care – what’s it worth?

While the Cavendish Coalition, with formidable representation of both the NHS and private social care sector, lobbies to protect the position of EU workers in a post-Brexit Britain, the biggest worry must be that these workers will vote with their feet.

When I last looked, 89 pence buys one Euro and many financial wallahs are predicting that the two currencies will continue to edge closer to parity. The incentive then, for EU citizens to come to the UK, or even remain here, and work is likely to dwindle; why work in an isolationist UK when similar wages can be earned in other western european countries?

But recruitment difficulties in health and social care go much deeper than Brexit and the question of overseas workers. The perception persists that care work is unskilled (it’s not); that it is a dead-end job (it’s not), and the unvarnished truth is that the low-pay status of care workers contributes significantly to these workers’ self esteem, and to how they are perceived by others.

Current wisdom is that only those care providers who truly value their staff will be successful in the long run. I hold that to be true but I think there are plenty of the Old Guard left who give lip service to valuing their staff while paying them little, enticing them with false promises of flexible working and not so much as providing even basic staff amenities.

These recruitment difficulties will not go away until some means is found to elevate care workers above their current position and to give them a fairer slice of their nation’s wealth.

The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

20th October 2017

CQC - Changes to how we regulate adult social care services

We will begin to implement changes to how we regulate adult social care services.

From 1 November 2017:

•We will regulate services using a single assessment framework for adult social care. This will strengthen our assessment by reflecting changes to the sector, the new best practice guidance, and how providers may develop their services in future. It will also simplify the process of assessment by aligning the questions we ask of different sectors and the characteristics that reflect a rating.

•New, simplified guidance on how CQC monitors, inspects and regulates adult social care services is available on the 'Guidance for Providers' area of our website. This guidance will replace the Provider and Inspector Handbooks, and will ensure both providers and inspectors use the same guidance documents.

•We will ask providers that are repeatedly rated as requires improvement to complete an improvement action plan to show how and by when they will improve their overall rating to good.

•We will introduce more proportionate and targeted inspections. Every service will receive a comprehensive inspection which considers all five key questions. We will also conduct focused inspections, targeted on areas of concern, risk or improvements, informed by Insight and information collection.

Phased implementation from January 2018:

•We will introduce an online process for collecting information from providers via a statement of quality about the five key questions and how providers are supporting continuous improvements. We will require providers to update this at least once annually, although more frequent updates can be made to record changes in quality, including improvements. This process will first be used with a small number of providers, gradually rolling out to all providers. Our aim is for full implementation by early 2018/19.

•During the transition providers will continue to use the current system for submitting information and will gradually be invited to start using the new online process. At the same time we will continue to test and improve the questions we ask and the process we use.

From April 2018:

• We will introduce a maximum inspection interval of 30 months for comprehensive inspections for services rated as good and outstanding. Until then, we will maintain current inspection frequencies of within 24 months, underpinned by ongoing monitoring using a broader range of information sources. We will continue to follow up and respond to risks and concerns through the use of focused inspections at any time. We will engage with stakeholders in advance of extending further the inspection interval for services rated as outstanding.

20th October 2017

What is lasting power of attorney?

For a person with a diagnosis of dementia, there may come a time when they are unable to make decisions about their care and their finances. A lasting power of attorney (LPA) is a legal document appointing one, or more, trusted people to be their attorney(s). An attorney is a person responsible for making decisions on their behalf.

There are two types of LPA. It is possible to draw up one, or both. The same attorney(s) can be appointed for both, or someone different can be appointed for each. They are:

Health and welfare, which appoints an attorney to make decisions regarding medical care, future care needs such as moving into a care home, and life-sustaining treatment. It can only be used once the person can no longer make their own decisions.

Property and financial affairs, which appoints an attorney to make decisions regarding managing a bank or building society account, paying bills, collecting benefits or a pension, or buying and selling a house. This can be used immediately if the person making it gives their permission.

“There is age discrimination, but I don’t think it’s deliberate,” England says. “We’ve become fixated on dementia in older adults as the one mental health issue to focus on, and common mental health problems of anxiety and low mood get neglected.”

One in five older people suffer from depression, yet their mental health problems often go unrecognised and they are much less likely to get psychological help than younger people. A government target, set in 2011 – for older people in England to make up 12% of referrals to psychological therapies – was missed by a mile.

NHS England, Public Health England, the Department of Health and NHS Improvement have today unveiled measures to boost the uptake of flu vaccinations along with package of new contingency actions to respond to pressures on frontline services this winter. Intensified preparations include:

•Providing free flu vaccines for hundreds of thousands of care home staff at a cost of up to £10m as well as increasing the number of jabs for young children in schools and vulnerable people

•Directing NHS trusts to ensure they make vaccines readily available to staff and record why those who choose to opt out of the programme do so

•Writing to doctors, nurses and other healthcare workers reminding them of their professional duty to protect patients by being vaccinated

•Setting up a new National Emergency Pressure Panel to provide independent clinical advice on system risk and an appropriate regional and national response

•The biggest expansion in training for A&E consultants ever with hundreds more doctors over the next four years and other healthcare staff

10th October 2017

CQC's annual assessment of health and social care in England now available

The report looks at the trends, highlights examples of good and outstanding care, and identifies factors that maintain high-quality care.

3rd October 2017

Most councils will not have enough care home places

Care of the elderly, or social care, has rarely been so high up the political agenda. Indeed, it blighted the Conservatives’ manifesto launch at the last election. Now a new report seen exclusively by Channel 4 News reveals that in five years’ time, nine out of ten local authorities in England will not have enough care home places to match the demand of the growing elderly population.

30th September 2017

Dementia is a terrible word. Why do people still use it?

Dementia is a word with a horrific impact.

I’m talking about the word and its origins, not the disease. I have observed people living well with dementia and this antiquated and negative term belittles the contribution to society that they can make. I am in my third year of a PhD and my research is based in care homes where I get to observe good care that challenges, includes and promotes a sense of purpose for residents with dementia. Before this I worked as a community nurse.

29th September 2017

Carrying the shopping can improve strength in over-65s, say experts

Carrying the shopping, gardening, or vacuuming, can help older people to lead healthier lives for longer, according to leading physiotherapists.

They warn that millions of older people risk falls because they are failing to maintain their strength.

Nearly a quarter of over-65s don't do any strength exercises, the Chartered Society of Physiotherapy (CSP) says.

And it warns that the rise of internet shopping means fewer people carry home their groceries.

Physiotherapists say not enough people realise the need to maintain strength as we age.

2nd September 2017

Will UK consumer law destroy the care home market?

Adult social care is on the financial ropes. Last year it was the introduction of the “national living wage”, this year it’s the requirement to backdate pay for sleep-in shifts. In both cases, the government is being urged to step in to prop up care providers.

31st August 2017

Care home creates lasting legacy by 'moving in' nursery children to end 'age apartheid'

The recent Channel 4 experiment ‘Old People’s Home for Four Year Olds’, which saw a group of four-year-olds ‘move in’ to a retirement village for six weeks, has proved that children really can give older people a ‘new lease of life’ and prompted researchers to ask 'why should we let our older people slide into deterioration and into a place where they feel hopeless?'

24th August 2017

Care home inspections are not fit for purpose. Providers need support, not more scrutiny

Inconsistent assessments and an inflexible appeal process make a mockery of care quality regulations. Now even the CQC recognises the need for change

A recent report by the Care Quality Commission (CQC) states the need for improvement in the UK care system. While 77% of care providers were rated as good, almost a fifth required improvement and 343 organisations were described as inadequate.

14th August 2017

Infection outbreaks in care homes: prevention and management

Outbreaks of infectious diseases in care homes can have grave consequences, so staff must be well trained in outbreak prevention, preparedness, detection and management

Care home residents share air, space, food and equipment, so they also share organisms that can easily cause infection outbreaks, such as viruses and bacteria. They are also more prone and vulnerable to infections, which can lead to death. Care home staff therefore need to be adequately trained to prevent, detect and manage an outbreak of infectious disease, and care homes must have an outbreak plan ready, to minimise the number of people affected and the harm done. This article summarises the principles of outbreak prevention, preparedness, detection and management, highlighting key practical guidance.

7th August 2017

Alzheimer's Society Forum

Alzheimer's Society's online community for anyone affected by dementia. Ask for advice, share information, join in discussions and feel supported.

Time is running out to tackle the crisis over pay for sleep-in shifts, which will cause problems for providers, their staff and the people who rely on care

After months of unsuccessful efforts to get the government to take the issue of sleep-in shifts seriously, last week Mencap began a public campaign to try to avert a looming crisis in the learning disability sector, and prevent Southern Cross type failures on a multiple scale across the country.

The HMRC has ruled carers sleeping overnight to provide safety and reassurance should be be paid the national minimum wage for all hours.

Mencap says the total bill for back pay - due by September, and in some cases dating back six years - could be £400m.

13th July 2017

Too many care homes fail to get the basics right

Headlines saying that one in three care homes has failed official inspections made tough reading for the social care sector, not to mention those with loved ones receiving care.

And while the main message from the Care Quality Commission (CQC) about the majority of care being good got lost in the furore, it is understandable that people focus on the bad bits. After all, poor care should not be tolerated.

11th July 2017

'It made me feel like I mattered': learning disability arts – in pictures

To celebrate its 30th birthday, creative arts charity Heart n Soul, which harnesses the talents of people with learning disabilities, has produced a series of portraits of some of the individuals it supports

This project is part of a wider festival of events. Find out more about what’s on, including live music performances, here

28th June 2017

Painless flu jab patch for people scared of injections

A 'painless' sticking plaster flu jab that delivers vaccine into the skin has passed important safety tests in the first trial in people.

The patch has a hundred tiny hair-like microneedles on its adhesive side that penetrate the skin's surface.

It is simple enough for people to stick on themselves.

26th June 2017

Spotting the earliest signs of Alzheimer's

Work is about to begin on a new study to find the earliest signs of Alzheimer's disease, many years before symptoms like memory loss and confusion become obvious.

Scientists believe this is the best time to be using drugs to stop Alzheimer's from developing further.

20th June 2017

Funding alone won't fix the social care system

Alzheimer’s Society is investing in three new research centres of excellence that aim to find ways to improve quality of life and care

The election campaign led the public to the misconception that the “dementia tax” is a new issue. The reality is that decades of squeezed government funding have left people with dementia and their families enduring inadequate care, crippling costs and impossible choices.

14th June 2017

Worries over care home fees and funding

Care homes may be charging families for extended periods after a resident has died as well as large upfront fees, a competition inquiry has revealed.

The concerns emerged from the initial findings of a review by the Competition and Markets Authority (CMA) which began in December

6th June 2017

'Compatible flexibility': the answer to social care's recruitment crisis?

Care work is billed as local and family-friendly, but the reality is unpredictable rotas and unsociable hours. This must change to stop the system collapsing

For those of us who have long been concerned about the state of social care, it’s a relief to see the sector so high on the political agenda. But while much of debate has centred on how future care will be funded, there is another critical issue: how to attract and retain enough care workers to keep the system working in an age of austerity.

8th May 2017

The apps taking on social care's 'broken' business model

Leila Karim* started doing care work two years ago, earning £8 an hour. It was, she says, a “chaotic” experience. There was a different manager every two to three weeks, the systems were all paper-based and “it was difficult getting to clients on time because we weren’t told when our next shift was”, says the 19-year-old student. “Sometimes you’d get a call at 6am to cover a call in the next hour or two.”

26th April 2017

Councils and health boards dispute £250m care costs

A £250m dispute over who pays for nurses delivering social care in residential homes in Wales has been heard by the Supreme Court.

The NHS pays for 24-hour healthcare, while general care needs are funded privately or by the council.

16th March 2017

The NHS-funded nursing care standard rate is being reduced to £155.05 from 1 April 2017.!

Care home managers play a pivotal role in raising quality standards, and more are needed

Janet Gilder has spent 42 years working in social care, more than half of that time as a manager. Today she runs a care home in Highgate, north London, where she is responsible for 41 older people with an average age of 93. Gilder has seen the manager role change over the past two decades as the sector has expanded and the culture of regulation and inspection has developed. “I think it’s a very different world today,” she says. “I came in as a qualified nurse but I think now it’s more about being an administrator – people aren’t necessarily coming in from a caring background.”

The Government recognises the pressures on the health and social care system. It is supporting the NHS’s own plan for the future and going further than ever before to integrate health and social care.

The Government knows that the NHS is facing many challenges and there are increasing pressures on all parts of the health and care system. It is important to remember that the pressures faced by the NHS are common to most developed health systems and are due to, amongst other things, an ageing population, changing public expectations and the cost of new drugs. However we have more doctors, more nurses, more paramedics all delivering more treatments than ever, funded by a budget at record levels.

The NHS and wider health system has already examined what needs to be done to ensure the sustainability of the health and care system. This is why in the Spending Review in November 2015, the Government committed to increase funding for the NHS in England, with funding to be £10 billion higher in real terms by 2020-21, compared to 2014-15. This is the money that the NHS in England asked for and will support the NHS’s own plan for its future – the Five Year Forward View – which set out what needs to change and how this can be achieved of this new funding. £6 billion will be provided by the end of this year, kick starting the process of change, and enabling the Government to deliver Government objectives including seven day services and improved access to cancer treatments and mental health services. The Five Year Forward View is available on NHS England’s website – https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf.

We are making progress towards strategic system changes and new models of care. There is emerging evidence that the vanguards have had a significant impact, reducing pressure on busy services at local level since their launch. In the Fylde Coast Local Health Economy vanguard for example, early figures show that bringing different health professionals under one roof to support older patients with multiple conditions reduced A&E attendance by 13%. We will continue to support this work to design a world class health system, fit for the future.

Alongside this, we are giving local authorities access of up to £3.5 billion of new support for social care by 2019-20, through the social care precept and the Better Care Fund. And aware of the more imminent pressures on social care, the Government took the necessary steps in the recent Local Government Settlement to help in the shorter-term, making available almost £900 million of additional social care funding over the next two years.

The Government believes that the answer to the challenges faced by the health and social care system lies in delivering more integrated services and keeping people well and independent for longer, and in working with the NHS in implementing its own plan for the future of the NHS – the Five Year Forward View.

The Petitions Committee will take a look at this petition and its response. They can press the government for action and gather evidence. If this petition reaches 100,000 signatures, the Committee will consider it for a debate.

If you wish to secure places on this, or any other course, then please visit the Learning Zone and log-in to online booking; or alternatively, reply to sam.manning@hants.gov.uk with participant details

3rd February 2017

CQC Feedback - A Summary

Sharing Best Practice

The latest summary of postives and areas for improvement from a selection of CQC Inspection Reports as up to February 2017.

The Grey Matter Group provide this document to support the sharing of best practice within the Adult Social Care sector.

HCA welcomed the 30p increase in the living wage from £7.20 an hour to £7.50, but warn that this would also push up the cost of delivering social care, putting an increased strain on local authorities that have already seen their budgets slashed.

There has been a steep rise in the number of patients fit to leave hospitals, but who continue to occupy beds because of problems arranging social care.

“Bed blocking” has dramatically increased with the highest recorded in August this year, this crisis situation can no longer be ignored.

All Adult Social Care Directors, LGA and NHS chiefs warned the chancellor's failure to act would mean more care homes closing and growing gaps in the market.

HCA call on the Government to rethink their decision and allocate immediate funding to stabilise our care and support system, as well as create a sustainable funding settlement for the future.

At the very least, money allocated to the Better Care Fund should be released immediately – not in two years’ time.